Clinical specificity profile for novel rapid acting antidepressant drugs
International Clinical Psychopharmacology – June 29, 2023
Source: OpenAlex
Summary
A new wave of pharmacology is reshaping psychiatry, with nine novel drugs showing promise for mood disorders. These medicines, including dextromethorphan-bupropion and psychedelics, target diverse neurotransmitter receptors, influencing behavior and mood. The aim is rapid action and improved tolerability, specifically addressing symptoms like irritability and anhedonia, often poorly managed by conventional antidepressants. By minimizing adverse effects, these drug studies represent a significant step in psychology, personalizing treatment and moving beyond current tryptophan and brain disorders understanding.
Abstract
Mood disorders are recurrent/chronic diseases with variable clinical remission rates. Available antidepressants are not effective in all patients and often show a relevant response latency, with a range of adverse events, including weight gain and sexual dysfunction. Novel rapid agents were developed with the aim of overcoming at least in part these issues. Novel drugs target glutamate, gamma-aminobutyric acid, orexin, and other receptors, providing a broader range of pharmacodynamic mechanisms, that is, expected to increase the possibility of personalizing treatments on the individual clinical profile. These new drugs were developed with the aim of combining a rapid action, a tolerable profile, and higher effectiveness on specific symptoms, which were relatively poorly targeted by standard antidepressants, such as anhedonia and response to reward, suicidal ideation/behaviours, insomnia, cognitive deficits, and irritability. This review discusses the clinical specificity profile of new antidepressants, namely 4-chlorokynurenine (AV-101), dextromethorphan-bupropion, pregn-4-en-20-yn-3-one (PH-10), pimavanserin, PRAX-114, psilocybin, esmethadone (REL-1017/dextromethadone), seltorexant (JNJ-42847922/MIN-202), and zuranolone (SAGE-217). The main aim is to provide an overview of the efficacy/tolerability of these compounds in patients with mood disorders having different symptom/comorbidity patterns, to help clinicians in the optimization of the risk/benefit ratio when prescribing these drugs.